In Africa, Climate Change Wages War on Bodies, Not Just Lands

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Kassahun Desalegn, MD, is on the frontlines of medical care, serving as the only dermatological specialist in a region of northern Ethiopia that is home to six million people. Desalegn also serves as department head and assistant professor of dermatovenereology at the University of Gondar, College of Medicine and Health Sciences, and is author and co-author of numerous peer-reviewed publications. He is a 2013 Aspen New Voices Fellow. Follow on Twitter @Kbilcha.

While the African Union concentrates on strategies to mitigate the devastating financial effects climate change is having on Africans, I worry instead about its impact on our bodies. As a doctor working in my native Ethiopia, I see the results of our warming planet, not just in the dry earth or the torrential skies, but in my patients every single day.

According to the World Health Organization (WHO) 2004 report on the global and regional burden of disease, at least 150,000 people die each year due to the direct effects of climate change. Of those, three percent die of diarrhea, another three percent of malaria, and just under four percent of dengue fever. Climate change is expected to trigger increased movements of people within and across borders. The International Organization for Migration estimates (that by 2050, between 25 million and 1 billion environmental migrants will move within their countries or across borders). Rural to urban migration increases migrants’ vulnerability to respiratory diseases and HIV infection. Migration is also one of the key causes of tuberculosis (TB) in countries which in the past rarely saw the disease, which often creates a steep financial burden for these countries.

Additionally, the prevalence of new and re-emerging mosquito-borne diseases is increasing worldwide due to climate change. Rising temperatures in the highlands allow mosquitoes and ticks to survive longer, leading to an increase in mosquito-borne diseases and the emergence of new diseases. Malaria, dengue fever and Leishmaniasis, a disfiguring disease caused by sand flies, are good examples. New kinds of Leishmaniasis have been detected across Africa.

I practice in the northern part of Ethiopia, a region where climate change is already hitting hard. Though what I have witnessed has not been confirmed by scientific study conducted in my area, broader data sets, such as from the WHO report on the global and regional burden of disease, indicate a trend of climate change leading to increased rates of disease. I believe I am witnessing the manifestations that these data suggest.

Recently, a school-aged girl with Leishmaniasis arrived at my clinic from the nearby highlands, where cases of the disease had previously been seen only rarely. Her 55-year old father, a farmer, gave me an alarming account of what he had been witnessing on his native land for the past five years. He said he had seen forests becoming more arid, soil eroding, the land becoming less productive, water becoming more scarce and new diseases occurring at alarming rates. Many children and adults in the neighborhood, he said, had the same condition as his daughter. Because the type of Leishmaniasis that his daughter had is resistant to all forms of available treatment, there was little I could do to help. This stigmatizing skin disease, which afflicts the infected person with sores and lesions that can cause permanent disfigurement, is becoming one of the main reasons for school drop-outs in Northern Ethiopia.

Dr. Kassahun Desalegn treats a young patient in his clinic in Gondar, Ethiopia Sept. 14, 2013. Credit: Rachael Strecher for the Aspen Institute

Climate change also impacts agriculture and livestock, increasing the prevalence of malnutrition and negatively affecting the health of children and pregnant women. It is estimated that 30 percent children under the age of five in Ethiopia are malnourished. The International Food Policy Research Institute estimates that by 2050 an additional 25 million people will be malnourished as a result of climate change. This is particularly dangerous because malnutrition, which has negative health risks of its own (macronutrient and micronutrient deficiency is a leading cause of childhood death in Africa), also increases people’s susceptibility to infectious diseases such as intestinal parasites, tuberculosis and HIV.

Droughts, which are also becoming more frequent due to global warming, dry up water supplies, especially in rural areas of the continent, forcing poor families to drink dirty, sediment-and-parasite-laden water and neglect their personal hygiene. This leads to increased occurrence of maladies like lice infestation, scabies and hookworm. Natural disasters such as hurricanes and floods can create breeding grounds for infectious diseases such as cholera.

Global climate change also has substantial negative impacts on people’s mental health and well-being. As people cope with the trauma of extreme weather effects, such as losing their homes or experiencing violence and ill health, they also suffer from forms of mental illness such as depression and anxiety.

In the past few years, people’s bodies have reflected a clear change in the environment. Some have argued that many of the dire health effects in Northern Ethiopia are the result of multiple generations of war and conflict. Though these conflicts have wreaked havoc on our society, many of the conditions I have mentioned, including malaria and Leishmaniasis, have manifested as a direct result of climate change and cannot be attributed to the political situation.

Too many people believe that climate change is something that will affect humans in the distant future, if at all. But I see its effects in my clinic now. Financial safety nets for farmers in Africa are not enough, and we must take significant steps to halt global warming before its effects become more serious—not just for Africans, but for the rest of the world as well. As we approach the time for the 2015 Millennium Development Goals to take effect, I hope that the international community increases its political efforts in this area. The international community must realize that this may in fact be the most crucial step we can take to improve the world’s health.

About the Author: Kassahun Desalegn, MD, is on the frontlines of medical care, serving as the only dermatological specialist in a region of northern Ethiopia that is home to six million people. Desalegn also serves as department head and assistant professor of dermatovenereology at the University of Gondar, College of Medicine and Health Sciences, and is author and co-author of numerous peer-reviewed publications. He is a 2013 Aspen New Voices Fellow. Follow on Twitter @Kbilcha.

“So much of the world is ignorant and poor and/or bound by myth/religious dogma, that even with the best intentions, we are stuck with the consequences of that…lots of babies continuing the cycle of ignorance and poverty. If children have not been raised to understand and care about the consequences of having so many children, and the support structures don’t exist to reinforce the point, you can’t change that. We don’t have the will or resources to change that, ever.

The fact is that the population will keep going until the damage to the environment tips so far as to kill billions upon billions of us, if not all. Whole populations will die out, and millions upon millions will MIGRATE and haves/versus have-nots will FIGHT and many developed societies will collapse under the strain Then eventually a much smaller population will be left in the mess that is all that remains of a once friendly ecosystem to pick up the pieces.”